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Related Experiment Videos

Complement and contact activation during cardiovascular operations in infants

J Sonntag1, I Dähnert, B Stiller

  • 1Department of Neonatology, Virchow-Charité-Hospital, Humboldt University, Berlin, Germany.

The Annals of Thoracic Surgery
|March 4, 1998
PubMed
Summary

Cardiopulmonary bypass (CPB) significantly increases the inflammatory response in infants undergoing cardiac surgery. CPB exacerbates complement activation and triggers contact system activation, unlike surgical procedures alone.

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Area of Science:

  • Pediatric Cardiac Surgery
  • Systemic Inflammatory Response
  • Cardiopulmonary Bypass

Background:

  • Infants undergoing cardiac operations may experience a systemic inflammatory response.
  • The specific contribution of cardiopulmonary bypass (CPB) to this response is not fully understood.

Purpose of the Study:

  • To prospectively compare infants undergoing cardiac operations with and without CPB.
  • To identify the components of the postoperative inflammatory response attributable to CPB.

Main Methods:

  • A prospective study involving 35 infants, divided into CPB (24) and non-CPB (11) groups.
  • Blood samples analyzed for complement function and contact system activation markers (C1q, C3, C4, C1 inhibitor, factor B, C3a, prekallikrein, factor XIIa).

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Main Results:

  • All infants showed decreased complement proteins; this decrease was more pronounced in the CPB group.
  • Increased C3a and factor XIIa, along with altered prekallikrein activity, were observed exclusively during CPB.
  • Complement activation was significantly higher in infants undergoing CPB.

Conclusions:

  • Complement activation is inherent to infant cardiac surgery but significantly amplified by CPB.
  • Contact activation was uniquely observed in infants during CPB.
  • The CPB circuit is the primary driver of the inflammatory response, with surgical procedures and anesthesia contributing to a lesser extent.